Corbin, Bradley Thomas

Corbin, Bradley Thomas is an individual health care provider with primary practice located at 1825 Kingsley Ave Ste 390 , Orange Park FL 32073-4484. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Corbin, Bradley Thomas can be contacted via phone (904) 639-2260.

Contact Information

Primary practice address
1825 Kingsley Ave Ste 390 Orange Park FL 32073-4484
Phone: (904) 639-2260
Fax: (904) 272-1986
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X ME158618 Florida
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 5171975 Idaho

Profile Details

NPI number 1104259548
LBN Legal business name Corbin, Bradley Thomas
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 20th, 2013
Last updated Dec 4th, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104259548 NPPES
Wisconsin MEDICAID 100088853

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